Who are the good guys in this story?
I spent far too much time this weekend on a Friday report from Peter Hancock, of Capitol News Illinois, headlined: “Federal drug discount expansion proposal may cost Illinois millions, agent head says.” Peter is an excellent journalist, so my consternation has nothing to do with his work and everything to do with the situation.
House Bill 2371, specifically a recent Senate amendment, would protect access to the federal 340B Drug Pricing Program. That program, launched in 1992, requires pharmaceutical companies to sell drugs at steep discounts to certain medical providers that serve large numbers of Medicaid patients.
Lower prices for prescription meds are positive, right? Sure, except in this instance, the purpose of the discount is so that those facilities can profit when selling the medication to patients. The bill would keep the drugmakers from throttling the program. Safety-net hospitals and clinics say they’ve recently run into those roadblocks, causing an unsurprising bottom-line impact.
On April 14, at a meeting of the Commission on Government Forecasting and Accountability, National Alliance of Healthcare Purchaser Coalitions President/CEO Shawn Gremminger essentially said the 340B program has expanded far beyond its original intent, implying it’s an unsustainable approach for drug developers.
But the Illinois Health and Hospital Association, responding to both that statement and a May 12 memo from the Illinois Department of Central Management Services, blamed “Big Pharma” for slanting the facts. Meanwhile, health insurance plans say they’re paying the fully marked-up prices and no longer receiving manufacturers’ rebates.
The CMS report said Illinois employers already pay $224 million each year through the 340B program, and HB 2371 could increase that by $89 million. Specific to the State Employees Group Insurance Program, the current costs are $31 million in annual lost rebates, with projections of an additional $12.4 million in losses.
This is, of course, a surface-level summary of in-depth reporting – visit tinyurl.com/CNI-340B – that itself contains outbound links trying to provide useful context to help the entire thing make sense.
I’m taken by a quote from state Sen. Dave Koehler, D-Peoria, who acknowledged that the plan isn’t the best solution, but rather his strongest idea within the framework of federal rules. That sentiment feeds into a larger problem with the American healthcare system: no one really knows how much anything actually costs because there are countless layers of paperwork separating someone who is sick from whatever makes them healthy.
Add in the general ineffectiveness of Congress, and the result is state lawmakers trying to respond to constituent complaints while all other interested parties seem focused entirely on who makes how much money once all the dust settles.
It seems an untenable situation, yet there’s no exit ramp in sight.
• Scott T. Holland writes about state government issues for Shaw Local News Network. He can be reached at sholland@shawmedia.com.
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May 19, 2026 at 10:04AM
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